Clinical and Histopathological Correlation of Cutaneous Leishmaniasis in Pir Panjal region of Jammu and Kashmir, India

Introduction: Cutaneous leishmaniasis has a wide distribution, spreading from the Indian subcontinent, across Central and South -Western Asia, to the Mediterranean Basin, the northern half of the African continent, and Central and south America. In India, it is endemic to the Thar Desert of Rajasthan. Some cases have been reported from the north western region of Indo-Gangetic plain. The present study was aimed to see the correlation of clinical features and histopathological findings in clinically diagnosed cases of cutaneous leishmaniasis in Pir Panjal region of Jammu and Kashmir which is nonendemic area. Material and Methods: It was an observational and descriptive study and was conducted over a period of 1 year from June 2016 to May 2017 in Pir Panjal region of Jammu and Kashmir. 62 patients with clinically suspicious lesions of CL were studied with particular reference to different histological patterns. Clinical features were correlated with histological patterns. 56 of these were diagnosed as true clinical cases on the basis of criteria for clinical diagnosis and therapeutic response. There were 37 males and 25 females with an age range of 2 to 78 years. These cases were then subjected to slit skin smear and histopathological examination. Results: Out of 62 suspected cases, 38 (61.2%) were smearpositive and 24 (39%) demonstrated Leishman Donovan (LD) bodies in histological sections. 29 of the remaining cases showed one of the recognizable histological patterns seen in CL, 6 did not reveal any suggestive histology but responded to antimonial compound, and 1 turned out to be a case of Discoid lupus erythematosis. Conclusion: Keeping in view the magnitude of problem and limited resources, clinical features may be reliable for diagnosis but this health problem needs further epidemiological studies to know the vectors and parasite strains

Does systemic sclerosis affect thyroid functions? A study upholding association

Objective To study the association of clinical and subclinical thyroid dysfunction in patients of systemic sclerosis and compare with age and sex matched controls without systemic sclerosis

Methods This hospital-based study involved 56 patients of systemic sclerosis and 300 age and sex matched controls without systemic sclerosis. Thyroid function tests, such as thyroid-stimulating hormone [TSH], free tri-iodothyronine [T3], free thyroxine [T4], were advised in all cases, and anti thyroid peroxidase [anti-TPO] antibody, thyroid gland ultrasonography and fine needle aspiration cytology in selected patients only

Results Abnormal thyroid functions were found in 37.5% cases compared to 18.7% in control group, and 26.78% of cases had hypothyroidism compared to 16.7% among the controls. 21.4% patients among cases had subclinical hypothyroidism [SCH] compared to 13.33% among controls

Conclusion Thyroid dysfunctions are common in systemic sclerosis and the same should be evaluated as routine clinical profiling of patients with systemic sclerosis

Autologous noncultured epidermal cell suspension in case of resistant segmental vitiligo: a preliminary study

To assess the repigmentation efficacy of noncultured epidermal cell suspension [NCECS] in case of resistant segmental vitiligo. Three patients having resistant segmental vitiligo were treated with noncultured epidermal cell suspension at the Department of Dermatology, STD and Leprosy, SMHS Hospital [associated teaching hospital of Govt. Medical College, Srinagar] and were followed up for six months. Two patients showed more than 70% response, one patient more than 50% response. The pattern of pigmentation was uniform and aesthetically acceptable. Autologous non cultured epidermal cell suspension is one of the best modalities as far as segmental vitiliginous patches resistant to other treatment modalities are concerned and is one of the novel techniques as far as its outcome is concerned in the form of uniform pigmentation

Angiokeratoma corporis diffusum without systemic features in a young Kashmiri female: a rare occurrence

Angiokeratoma corporis diffusum [ACD] is a variety of angiokeratoma, characterized by diffuse cutaneous hyperkeratotic vascular lesions. ACD is usually associated with many lysosomal enzyme deficiencies, though it is not a rule. It is associated with systemic features along with skin lesions. It may also present as isolated cutaneous form. X-linked recessive form usually manifests in males and females act as carriers. We report a case of ACD without systemic features in a young Kashmiri female.

Blue rubber bleb nevus in zosteriform pattern: a rare case report

Blue rubber bleb nevus syndrome [BRBNS] is a rare condition with lesions in skin and/or other visceral organs, predominantly gastrointestinal tract. The condition is not fatal, unless associated with systemic involvement. BRBNS can also present as cutaneous lesions only. We report a classical case of BRBNS in zosteriform distribution, involving C6 and C7 dermatomes, in an adult Kashmiri male, a rare presentation.